Provider Demographics
NPI:1134946759
Name:ROYAL GUTE, KESHA ALICIA (MSW, LGSW)
Entity type:Individual
Prefix:
First Name:KESHA
Middle Name:ALICIA
Last Name:ROYAL GUTE
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:KESHA
Other - Middle Name:ALICIA
Other - Last Name:ROYAL GUTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3257 RUSSELL AVE N STE 202
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55412-2234
Mailing Address - Country:US
Mailing Address - Phone:651-401-2134
Mailing Address - Fax:
Practice Address - Street 1:PEOPLE FIRST CLINIC PLLC
Practice Address - Street 2:652 BIELENBERG DRIVE SUITE 202
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125
Practice Address - Country:US
Practice Address - Phone:651-401-2134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN30028104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker